A Cure for Rancho's Ills

Advocates for the disabled have asked a federal judge to stop Los Angeles County from closing Rancho Los Amigos National Rehabilitation Center on June 30. It should indeed be kept open, but unless the judge also hands Rancho a vault full of cash, an injunction won't fix the problem.

Rated one of the nation's top 10 centers for treating brain and spinal disorders and injuries, the county-run hospital works miracles for 9,500 people a year. Young adults triumph over devastating injuries to become wheelchair athletes. Children with cerebral palsy and older patients with strokes learn or relearn to walk. People become able to live on their own and hold jobs again. Rancho innovations such as the halo cervical spine immobilizer have helped countless others who weren't even patients there.

Rancho's plight is the county health crisis in microcosm: a huge need for treatment and no way to pay for it. An injunction would force the cash-strapped county to find cuts elsewhere in a system already straining to care for an estimated 2 million residents who lack public or private medical insurance.

Into this impasse stepped the nonprofit California Community Foundation, which last fall commissioned a study to see whether Rancho should and could be saved. The answer, released Monday, is yes and yes -- providing that it become a private nonprofit hospital.

The blueprint calls for retaining Rancho's respected physicians and clinicians. It would staunch red ink in part by streamlining the hospital administration, described as overstaffed and inefficient because of outdated technology, a byzantine bureaucracy and union rules. The antiquated billing system is not even set up to itemize costs and to charge private insurance companies.

Other Southern California hospitals that provide rehabilitation -- none as large or with as many specializations -- cherry-pick patients with private insurance and send those without to Rancho. The report calls for the new Rancho to compete for paying patients to balance out the money lost on treating the indigent and those on Medi-Cal, California's version of Medicaid. More paying patients would mean fewer beds available for the poor. Not as few, however, as if the hospital closed.

The challenge is to recruit a board or, ideally, an already established hospital willing to run a new nonprofit. A court injunction alone would only put the terminally ill hospital on life support.

The California Community Foundation has shown the way to a cure. Now all that's needed is a handful of miracle workers.

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To Take Action: For more information on the campaign to save Rancho Los Amigos, call the California Community Foundation, (213) 413-4130, or go to www.calfund.org.